Organization Active NPI

Dra. Dianne Carrasquillo L.L.C.

  • Dermatology Physician
  • San Juan, PR
National Provider Identifier
1043986953
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
DRA. DIANNE CARRASQUILLO L.L.C.
Practice address
142 Calle del Parque
San Juan, PR 00911-1965
Phone
(787) 725-1100
NPI assigned
Aug 19, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Dianne Carrasquillo, MD
Title
President
Phone
(787) 405-1271

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

142 Calle del Parque
San Juan, PR 00911-1965

Mailing address

286 Ave Domenech
San Juan, PR 00918-3506
Phone (787) 314-4443

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250717003775 PR Part B Supplier - Clinic/Group Practice 6800302837 Receives reassigned benefits from 1 practitioner
Practice locations: Dorado, PR; San Juan, PR

National Provider Directory

National Provider Directory

Locations

286 Calle Manuel Domenech
San Juan, PR 00918
Phone (787) 314-4443

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1629331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743552000000",
    "number": "1043986953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "286 AVE DOMENECH",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009183506",
            "telephone_number": "787-314-4443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 CALLE DEL PARQUE",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009111965",
            "telephone_number": "787-725-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRA. DIANNE CARRASQUILLO L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-19",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A",
        "authorized_official_last_name": "CARRASQUILLO",
        "authorized_official_first_name": "DIANNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-405-1271",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.